hyperthyroidism ?

[lonny77]

Hi,  My wife, who is 63 years-old, has had a rapid teart rate an for several years.  She has also experienced off-and-on arrhythmias through the years that she has doctored for, but they have always ended without any resulting roblems.  She also has extreme heat intolerence.  While everyone else is comfortable, she is burning up.   This problem seems to be getting worse with time.  During the last few years, she has lost a lot of weight, even though she eats just as she always has.  Her doctor, a general practitioner, has run blood tests to check for thyroid problems, but the results were negative.  My questions are:  Are blood tests for thyroid problems always conclusive, or could she have thyroid problems even though the blood tests have ruled them out?  Any other thoughts concerning the health conditions I have described.would be appreciated.  Thank you for your expertise and time.    

[Jigisha S. Amin, MD]

Without a review of the complete history, physical exam, lab test results, and medication list, I can’t give you an accurate diagnosis or treatment plan.  Your 63 year-old wife has a several year history of heart arrhythmias, rapid heart rate, heat intolerance, and weight loss with repeatedly normal thyroid results.  The third-generation TSH assays that are used these days are highly sensitive, so yes, the tests would have more than likely picked up on a thyroid abnormality.  Bulging eyes, an enlarged thyroid (goiter), non-pitting edema of the extremities are other clues that would make your doctor suspect Grave’s hyperthyroidism.  A thyroid ultrasound would show nodules and further testing could reveal one that is autonomously functioning, but the thyroid blood test is also usually abnormal in that case.  Do you think anxiety may be playing a role in her symptoms?  Is she taking any herbs or other meds that could be contributing to her symptoms?

[lonny77]

Thank you very much for the information you sent regarding my wife's problems with heat intolerance, rapid heart rate, arrhythmias, and weight loss.  To answer your questions about anxiety and herbs, neither seem to be a problem.  She doesn't take herbs and is a calm person.  Her rapid heart rate started in the mid 70s, and her heat intolerance  started slowly a couple of years ago, but ,as mentioned, is growing increasingly worse.  Weight loss began approximately 1 year ago, and she has had sporadic, but short-lived, arrhythmias since the mid 70s.  Thank you again for taking the time from your busy schedule to answer my questions.   Sonny77  

[Jigisha S. Amin, MD]

My pleasure.  It sounds like the other issues are long-standing, stable problems.  What concerns me just a bit is the unintentional weight loss.  At her age, she should definitely get her routine cancer screening tests done (mammogram, pap, fecal occult blood testing) and any other tests based on history/symptoms/signs that your doctor feels necessary.